Preventing Fungal Infections After Endothelial Keratoplasty

In this interview from AAO 2018, Dr. Bennie Jeng offers advice for reducing the incidence and morbidity of fungal infections after endothelial keratoplasty. Rates of bacterial infection after keratoplasty began to drop in the early 1990s when antibacterial agents were added to Optisol, but infections have been on the rise since 2006, which coincides with the increasing popularity of endothelial keratoplasty. Adding antifungal agents to the Optisol solution used to store corneas may help prevent infections, Dr. Jeng notes. Culturing the rim at the time of surgery is another option, but it is unclear how best to proceed when a culture result is positive. Because oral antifungals are reasonably toxic, he prefers to examine patients with positive culture results carefully and frequently, and will only start treatment after there are definitive signs of infection.

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